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If You Build Walkable Neighborhoods, They Will Walk (and Lose Weight, Too)

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If You Build Walkable Neighborhoods, They Will Walk (and Lose Weight, Too)

Written by Dana K. Cassell
| Published on June 17, 2014

Making neighborhoods more conducive to walking and biking would lower rates of obesity and diabetes by helping people be more physically active, studies show.

In one of two comparison studies presented at the American Diabetes Association’s (ADA) 74th Scientific
Sessions, Canadian researchers found a 13 percent lower incidence of
diabetes over a 10-year period for people living in “walkable”
neighborhoods.

A walkable community is defined by the Federal Highway Administration
(FHWA) as one where sidewalks, trails, and street crossings are safe,
accessible, and comfortable for people of all ability levels. Additional
measures used by the researchers included less sprawl, more
interconnected streets, and more local stores and services within
walking distance.

According to a second study, which compared
neighborhoods instead of individuals, the most walkable neighborhoods
had the lowest incidence of obesity, overweight, and diabetes. Rates of
these conditions rose 13 percent in the least walkable neighborhoods in
the same period.

Diabetes Rates on the Rise

More
than 29 million people in the U.S. have diabetes, up from the previous
estimate of 26 million in 2010, according to a report recently released
by the Centers for Disease Control and Prevention (CDC). Another 86
million adults have prediabetes, with blood sugar levels higher than
normal, but not high enough to be classified as type 2 diabetes. Without
weight loss and moderate physical activity, according to the CDC, 15 to
30 percent of people with prediabetes will develop type 2 diabetes
within five years.

Marisa Creatore, an epidemiologist with the
Centre for Research on Inner City Health at St. Michael's Hospital in
Toronto, noted in a press statement that one’s environment can influence
decisions about physical activity. “When you live in a neighborhood
designed to encourage people to be more active, you are in fact more
likely to be more active,” she said.

Agreeing “absolutely, without
a doubt” that walkable communities could dramatically lower diabetes
rates is Jerry Meece, R.Ph., CDE, FACA, owner and director of Clinical
Services, Plaza Pharmacy and Wellness Center in Gainesville, TX. “We can
spend mega millions of dollars getting new drugs on the market, but if
you're taking a drug, and you're not eating properly, and you're not
getting exercise, then those drugs are wasted,” Meece told Healthline.

Let's Get Physical

Meece
described diabetes management as a three-legged stool, with medication
as one leg, nutrition another leg, and physical activity the third leg.
“If physical activity is missing, that stool falls apart,” said Meece.

The
way to improve on the CDC's projections is not by taking more
medicines, but by changing one's diet and activity level, emphasized
Meece. "Everybody’s hoping for a cure, but what's going to make a
difference is getting people off their rears and more physically active.
And you do that by making it the right thing to do, the easy thing to
do,” he said.

Illustrating his point, people in the studies who
lived in the most walkable neighborhoods were three times more likely to
walk or bicycle and half as likely to drive to their destinations.

Meece
noted that when health providers tell diabetics to get out and walk or
ride a bike, they sometimes forget it’s not always easy for people to do
so. “You basically take your life in your own hands a lot of the times,
getting down city streets, so for some people, that's all it takes not
to get exercise,” he said.

However, Meece cautioned, “You have to
be careful when saying people who walk and bike in these cities have a
lower incidence of diabetes. I don't doubt that a bit. But the people
who are doing so are also the people who probably eat better to begin
with. They're more health conscious.”

How We Build Our Cities Matters

The
studies’ lead researcher, Dr. Gillian Booth, an endocrinologist and
research scientist at St. Michael's Hospital and the Institute for
Clinical Evaluative Sciences (ICES) in Toronto, noted in the press
statement, “We have engineered physical activity out of our lives. Every
opportunity to walk, to get outside, to go to the corner store, or walk
our children to school can have a big impact on our risk for diabetes
and becoming overweight.”

However, she cautioned that solving the
obesity and diabetes epidemics will require public policy changes as
well as individual attention. “We have to take a more population-based
approach to the problem, given the environment we live in,” she said.

Meece
added ,“We need to develop walking/riding trails. We need to make
intersections possible instead of cul de sacs and dead-ends. You can
plan these, but it costs money. It takes time, it takes planning, and it
takes community involvement.”

In addition to saving lives and
helping people live healthier, walkable neighborhoods could be less
costly in the long term. “But the key question is less costly for whom?
Is it less costly to a city? No. Is it less costly to Medicare? Yes,”
said Meece, adding that the problem is that hospitals, community
governments, Medicare, and others all pull from different money pots.

“No
one’s saying, let’s spend $25 million to develop a walking trail, and
that will save us money; because those dots are never connected. But
someone has to connect those dots," Meece said. "It’s the only way we’re
going to be successful in making walkable neighborhoods a reality.

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